A Message from 999 Call for the NHS

This autumn, 999 Call for the NHS will be in the Court of Appeal for a 2 day hearing of our appeal against NHS England’s Accountable Care Organisation contract.

The Court of Appeal has granted us permission on ALL seven grounds we applied for, to appeal the High Court ruling that dismissed our Judicial Review claim.

The Court of Appeal has also granted us capped costs because the NHS is important to the public; and the complexity of the legislation means our case is worthy of consideration at a higher level than the High Court.

We now need to raise £18K. This will be used to meet  the capped costs limit that we would have to pay NHS England if we were to lose the appeal.

A vital matter of public interest

Our Judicial Review, held at the High Court in Leeds on 24th April, challenged the lawfulness of a way of paying for NHS services that NHS England has introduced in its new Accountable Care Organisation contract for 2017/18 – 2018/19.

Called a “Whole Population Annual Payment”,  this is basically a fixed annual sum paid to an accountable care provider (which NHS England has now renamed an “integrated care provider”).   It is intended to cover a population area, regardless of the number or complexity of  NHS services provided.  The provider would be paid at the start of the year, before it has carried out any treatments. It would impose obvious financial pressures and risks on the provider of NHS treatments.

We think this cost-cutting payment mechanism would undermine the NHS as a high quality service that provides the full range of appropriate treatments to everyone, on the basis of clinical need.

If introduced into the English NHS, it would restrict access to NHS treatments, accelerate the creation of a two tier health system where people with money pay to go private while the rest make do with a limited NHS, and increase privatisation.

The Court of Appeal has expedited  our appeal because NHS quangos are already spending considerable sums of public money on the assumption that the Accountable Care Organisation Contract is lawful.

NHS England is already in the middle of a public consultation on the Accountable Care Organisation Contract (which they’ve renamed the Integrated Care Provider contract) – despite the fact that it may not be lawful.

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Two main legal issues at the heart of our Appeal

First is whether NHS contracts can lawfully be awarded on the basis of price competition between rival bidders. This would be the effect of the Whole Population Annual Payment, since it would pay for NHS services without “visible prices fixed in advance for each individual treatment episode”.  The Judicial Review ruling said this was lawful.

However, we think that it would allow providers bidding for an Accountable Care Organisation contract to try and undercut each other on price – creating a race to the bottom, in terms of the quality and accessibility of NHS treatments.

The second legal issue arises from our Judicial Review argument, that because Parliament clearly intended that the Health and Social Care Act 2012 would not lead to price competition between providers bidding for NHS contracts, the Accountable Care Organisation contract would be unlawful if it had this effect. Which we think it would.

In dismissing our Judicial Review,  the judge ruled that this “is a political objection and not a matter for the court.

We could not disagree more.

While we are no fans of the 2012 Health and Social Care Act – which increased private companies’ access to NHS contracts, fragmented the NHS and removed the Secretary of State’s duty to provide a universal, comprehensive health service in England –  we think it is vital for the future of the NHS that decisions about the future of the NHS are made lawfully.

Otherwise, what is the point of Parliament, if government quangos can ignore the laws it makes?


How you can help

We need to raise £18,000 to cover the costs of our #Justice4NHS Appeal. 

Over 1400 people have helped get us this far, by crowdfunding the costs of our Judicial Review & Application for Permission to Appeal.

We hope you will help us continue with the fight for our NHS.


  • give what you can, every penny helps
  • share this page with friends, family and social media networks
  • consider working this legal challenge into your campaign group’s actions, if you’re part of one

This is a vital matter of public interest. The more we stand together, the better our chance of protecting our NHS.
Thank you

Jenny, Jo and Steve

Who we are

We’re ordinary people determined to protect the NHS as a high quality comprehensive public service,  free at the point of use for all who need it.
In 2014, with great support from the public and media, 999 Call for the NHS marched 300 miles from Jarrow to London to save the NHS. Over 20,000 people gathered in Trafalgar Square to support this urgent call.
We’ve carried on campaigning ever since. For the last two years, we’ve been marching to the law courts.

Please join us on this final leg.